Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors

Objective: Delivering prognostic information to families requires clinicians to forecast an infant’s illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician–family concordance regarding infant outcomes. Study Design: Prospective audioreco...

Full description

Saved in:
Bibliographic Details
Published in:Journal of perinatology 2017-11, Vol.37 (11), p.1224-1229
Main Authors: Boss, R D, Lemmon, M E, Arnold, R M, Donohue, P K
Format: Article
Language:English
Subjects:
692/308
706/648/179
Analysis
Care and treatment
Communication
Conferences
Conferences, meetings and seminars
Counseling - standards
Critical Illness - psychology
Critical Illness - therapy
Critically ill children
Diagnosis
Disclosure of information
Diseases
Empirical analysis
Female
Health aspects
Humans
Infant
Infant, Newborn
Infants
Intensive Care Units, Neonatal
Male
Medical prognosis
Medical schools
Medicine & Public Health
Neonatal intensive care
Neonatal intensive care units
Neonates
Neonatology
Newborn infants
original-article
Parents
Parents - psychology
Pediatric diseases
Pediatric Surgery
Pediatrics
Perception
Professional-Family Relations
Prognosis
Qualitative analysis
Qualitative Research
Quality of Life
Surveys
Truth Disclosure
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: Delivering prognostic information to families requires clinicians to forecast an infant’s illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician–family concordance regarding infant outcomes. Study Design: Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied. Results: We analyzed 19 conferences. Most prognostic discussion targeted predicted infant functional needs, for example, medications or feeding. There was little discussion of how infant prognosis would affect infant/family quality of life. Prognostic framing was typically optimistic. Most parents left the conference believing their infant’s prognosis to be more optimistic than did clinicians. Conclusions: Clinician approach to prognostic disclosure in these audiotaped family conferences tended to be broad and optimistic, without detail regarding implications of infant health for infant/family quality of life. Families and clinicians left these conversations with little consensus about infant prognosis.
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2017.118